Multifocal retinal contraction in macular pucker analyzed by combined optical coherence tomography/scanning laser ophthalmoscopy.

PURPOSE To characterize the topography of macular pucker using coronal plane imaging in vivo, and correlate this with transverse optical coherence tomography (OCT) to assess the relationship between topographic features and severity of disease. METHODS Forty-four eyes with macular pucker underwent full ophthalmologic evaluation including B-scan ultrasonography as well as coronal and transverse plane imaging with combined OCT/scanning laser ophthalmoscopy (SLO). RESULTS Posterior vitreous detachment was present in 37/44 eyes (84.1%) by ultrasound. Multiple foci of retinal contraction were detected in 20/44 eyes (45.5%) by coronal plane OCT/SLO. Intraretinal cysts were present in 6/9 (66.7%) eyes with three or four contraction centers as compared to 10/35 (28.6%) eyes with one or two contraction centers (P = 0.05). Eyes with three or four contraction centers had significantly (P = 0.05) thicker maculae (369 +/- 98 microm) compared to those with one or two contraction centers (297 +/- 110 microm). CONCLUSION Coronal plane imaging detected multifocality in nearly half of eyes with macular pucker. Eyes with multiple retinal contraction centers had greater retinal damage compared to eyes with one or two contraction centers. Multifocal retinal contraction may have clinical significance in that it may impact on prognosis and management.